Which clinical history findings are characteristic of lumbar disc disease?

Updated: Sep 25, 2018
  • Author: Kamran Sahrakar, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Most lumbar disc herniations (lumbar disc diseases) are preceded by bouts of varying degrees and duration of back pain. In many cases, an inciting event cannot be identified. Pain eventually may radiate into the leg. It may be characterized as less achy, burning, or similar to an electrical shock and is often described as a shooting or stabbing pain. The distribution of the leg pain is somewhat dependent on the level of nerve root irritation. Higher herniations (third or fourth lumbar levels) can radiate into the groin or anterior thigh. Lower radiculopathies (first sacral level) cause pain in the calf and bottom of the foot.

Fifth lumbar radiculopathy, which occurs most commonly, causes lateral and anterior thigh and leg pain. Often, accompanying numbness or tingling occurs with a distribution similar to the pain. Accompanying muscle weakness may be unrecognized if the pain is incapacitating. The pain usually improves when the patient is in the supine position with the legs slightly elevated. Patients are more comfortable when changing positions. Short walks can bring relief. Long walks or extended sitting (especially driving) can aggravate the pain.


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